by Proactive LTC Consulting | May 1, 2024 | Admissions, Medicare, Q&A
Q: I have a resident that was admitted Medicare part A on the 11th, discharged to the hospital on 13th and is returning today (22nd). Is her admission MDS due earlier because of the 04/11 admission date? A: The admission assessment should be reinitiated... by Proactive LTC Consulting | Nov 21, 2023 | Blog, Compliance, Documentation, Medical Review, Medicare, Nursing, PDPM, SNF
SNF Meetings– UR & Triple Check Essentials According to a recent Agency Financial Report released by the Department of Health and Human Services (HHS), the primary reasons for SNF payment error include (1) missing or insufficient documentation to support the... by Proactive LTC Consulting | Sep 12, 2023 | Blog, Compliance, Medicare, Physicians
MACs have begun rolling out the mandated 5-Claim Probe and Educate audit and will eventually review claims for every eligible SNF in their jurisdiction. SNF certifications and recertifications are important elements of SNF Medicare stay compliance and will be... by Proactive LTC Consulting | Aug 30, 2023 | Blog, Medicare, Nursing, Quality, SNF
How much of your time is spent in meetings? Depending on your role, time in meetings may take more time than any other task or responsibility you have. Do you sometimes wonder if all these meetings are even necessary (“Could this have been an email?”) Days are busy... by Proactive LTC Consulting | Aug 23, 2023 | Blog, ICD.10, Medicare, PDPM, Reimbursement
PDPM has been in place for nearly four years, and with it came the shift from payment based on resource utilization to payment driven by patient characteristics and service provision. PDPM presents with many nuances and complexities that open the door to sinking... by Proactive LTC Consulting | Aug 9, 2023 | Appeals, Medical Review, Medicare, Q&A
Q: My facility is going through a Medicare UPIC review and received a significant number of denials followed by a demand letter requiring repayment. What are our options for appealing the decision and what is the interest rate that will apply if we aren’t able to...